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Home My WebLink About0874 • 3 CERTIFICATE OF DEATH ~ ~r ~ Dey.r~wewt .f Ik.1~6 .wd Re6~L~L~~~i.e Ser.kra 9TATE FILi Ho. ~ on~w~a. i~,~.m F L O R I D A 66' i~?E. O~ ?tlt~li IM ~`~°~~uR•TM" REGISTRAR~S NO. ~[tMAlIINi INK rwpF ~~st ~x OATE Of DEATM ~ rortw, o~~, rt~~ ~ ~ se~ ru~two~ Fa oECCwsEO-N,~AY.A s A:~'~.'~.Y NEZS4?i s ~ A`ARY At~... IA N t Female ~ December 1 1. ~ tACE ~.an..•~cw.••euc... ~.~o~.», wGE-ua~ . w+oe~ ~.e•~ u«w~ ~ w. DU~E Of NtiH i..o«m. w~. 'GOVNTY Of OEwiN ~ ~x. ~i1~lt@ wn.o.. ~nus~ ros w~s wws ..r+- . 6 A k ~Dec. Z 1 0 Broxard t CrtY. 10~. OR IOUiWN af OEAiM wuw c~n ~w~n MpS~1Al OR OTMER NSi1TU1~Wi-NM~f ~+o? ~w un.t~, cnr~ srnn •w »wu~~ ~ /~/jti s.scws .~s o~ ..o Eollyxood Yes '+lashin on A'-anor Nursi Home S1AiE Oi tIITN ~ r r~ot ~M u 3~-. w~ ~~nZEN Of ~MIUT COUNTRIf MARRKO. NEvER MARRtfO. SIMVIrNG SiOUSE ~~~t. G^n ~ cawm ~ WDOwEO. Dh/ORCED ~ sntn ~ ~,~u , *'eKf'oundland • CT. S. A. N A'arried u. N'artin L. Nelson ~ .~.e~e oece.seo ~~~1 SEGLRITY NUWER USU~1 OCCIMAT~ON IfNl~ [MO O~ W~[ OOME 011~IMG rOS? M [wD Oi M15wESS OR 1NOtJSiR1f ~ u.eo u a.a~ rwaw ~ue. e.e.. u nn~ea ~ " o8a2a ~+37 Home~aker OKn Horce ~~sT..urw+, ane ees w~+ce arou wswe em u..m Si[EET ANC NU~Et ~ .owiso«_ RE51DEtiCE-SiAiE COUNiY Uir. iOWN. OR tOCAT10N _ • ~snan ns M No { ~y r'lorida ,u Broward ,k ??olly~+ood , Yes 2418 Fol~c StrEet ~ fAfHER-NAMf - I~q/ r~! ui~ MOTHER-MA~fN HAME ~ntt w00~t ~u „ D~.vid McGrory. N.ary Walsh ~ INIORM~NT-r~~f Mwl?NG wOGtESS ~srun o~ ~.r_o. «o . cm w wvN, sr.a. :r~ P~. Jonn J. r:elson ~n 6t+41 Lee Strpet ~ Holly~rood, Florida 3302~ ,F j..µ ~ 1wRT 1. pEwiH wwS V.USED 6Y. r~uSE ?f~ lM+f ~OR 101 ebf ANO l~13 1~tn.rer Cws~~ ~•~o M•~ ' u wrouR c ~ . /t~~ - / ~e~ r fi~ t~ Z ; . »seov .+ce o ~ . COMOI~IOMS. ~M, • ~ ~w~cr c••[ ns~ ro Ib) ~ ~rww~~e c~ust ~o:, ~ *o. a ~a ~ cd+seou~«ce or: • sr~uMC ~we v.+oe~- ~ a•u.e c.~se us~ i kl fARi OtaER S~G+UF~CIwT COr~WT10NS: caw~nws cawww~.w w oeww ~w ..oi •wno io uuu e~M w+ .v* ~ a~ ~a511 If 1/E5 r.eu riwo~¦es eo~-~ ~~es w•a~ oi oeiiN~ oerea..,.,wo u~rse~ N~ H~ IN p~pub1~ ACGOENi. SUK1Df Ot A E Y irowtM, wr, ~e•i ~ qpW INIURT OCCURREO ~ t~~ w*~ p~N~un ~N rw~r ~ o~ r~n u, atr u~ ~I qprIGOE; Ot tInDETERMtNED - ~ 1Se~dr1 i~v ~ ~ ~ ~ R I?Wt1f AT wORK ?lA[E Of NA1RY .r wore. r.e., s~~en, r.no~r. lpUnp~ ~ snen o~ a.r.o. Mo., e~n o~ ro+m. sua ~ t ~srfc.n ns o~ .wi oa,c[ Mnc..tu. ~sMOn~ - ~ 4 i ~ ~ ; CERTIFKATIpN- ..o-.*M ar ~ +~TM a• s~r MW/N!~ Allr! OM 1 04/D~D MOt n[~ 1w[ DEAtM OCCU~tED n~ n~ce, a, ~we ? rOun~ wr rW ~OO* un~ awM. ~MOV~~ owie. u+o, t0 n~! ~es-; ~M11KI~.N: T~ (~ry ~f~y K~" Oi r1 [NO'M~lOGF. P.1 ~~nt~+o[o n~E .?O 12 17 ~71 3. tl~ ~O~ ~ ~I! /~/VV~ tl~ ~ Z~Jr~ t0 n~e 4uSt~1~ P.~e~: tl~ oKe.uo ~w. ~ •~,J ~ t!\ CERi~1Gi1C1~i-MEDKAI ExAM~P1ER OR COlONER_ ou tw~ us~s or nt wow or a•m TMe aeEOe..~ .r.s rw..ou,+eeo oe.e ~ : lww.•TKw O~ M! MDOt ~MlOt Tw! wrlStiG~tpr~. w r~ Wwqw. ~T ~W w•m occw~to oN nrt o~rt ~rW Dtrt /O iM[ UYSF~SI Si~RO. . M~ ~ - Al t1?. GFRTtf NAME mr[ o~ r~ T~ SK~+tA ~e DATE SIGNEO ~rd.a, ow~. re.~~ n : ~ fr! ~ : ~ ~ - ~ ~ - ~ isr ~ !1G AODiESS-CEPi61Et si~~n Oa ~.r.o. ~M. un w to.« sr•~e. iw 750 Federal Hi rs~a Eoll ood Florida ?020 WR~N. CREMATION. 1iFMOvAI CEMEIER1f OR CREMAiORY-rr~E lOCwt10N an o~ ~ow.. sure 1 srtcr'~' ~ J~ ~w Eurial Holl ood t"emorial C~3ns. ~k. Holl ood Florida ~a OwTE :..w*N. w•, n.~~ FUNERAI MOl`tE-NAME wND ~DDRfSS / Slif[I W~./.D. MO.~ em o~ to~+.+, sr.re, t~r i a Dece*.nber 20 1 n. ~intter I~frb Ch~~e? s lOKG *I~ Fed HK :'oll~ woo. F"+z Y. 5. i612 ? ' DM~KTO~- - T-Jlt~ y _ REG~S,i~y ~t~ oan .:`f~,e~ ~r axu it ::::c.¦ ~ Rev.1970 n / GC%-[-~, i/5ay ~~i :w ~ ' - ' ~ . ~ ~ . _ _ ' . . ~+J3 S CERTIFI:.D COP'Y ~ ~ ~ ~ I hereby certify the above to b~ a tr~ae and correct copy of the Local Registrar's record on ~ile in the Broward County Health Department at 2'~~~8 ~ ~ Fort I,~uderdale, Florida. - ~ (~+ai-nin~: Not valid unless raised seal of the Broward County Health ~ ~ - ~Department is affixed.) " ` • • . _ _ ~i ~ c, ~ i' ~ ' ~r ~ ' . . ~ • w • a ' . ' Q-~ ` C ~ ~ _ ' ' ~r....t-~~ ~ ~ ' Cou ~ty Health Uffi • and Loc:~l iieEistrar ~ : ~ f , . T. ~ - y ' . • ` -~t C _ ~ t- f 1 r I. \ 1~ ~ , w c1 ? 1'1 . ~ ~b~~ , ~ r N ' - , lleputy L~al Itegistrar ~ ~ ~a ~ _ , . . . - ~00~2~5 ~~f 872 m, . ~ y~~,^~ b • ~ - _ ' F ~ ~ ~ '~~z~`-:;a t .rt: _ - ~ : - - ~ u _ d _ ~ .